Side Effects of Oral Appliance Therapy in Sleep Apnea Patients

Objectives: By means of a mail questionnaire, compliance and side effects of oral appliance (OA) wear were evaluated in patients with Obstructive Sleep Apnea (OSA).

Methods: All patients used a TheraSnore^TM for OSA treatment. The questionnaire was sent to 84 patients six months after insertion of the OA.

Results: Fifty eight % of the patients returned the questionnaire. There was no significant difference in the baseline data for age, Body Mass Index (BMI), Apnea Hypopnea Index (AHI) or Epworth Sleepiness Scale (ESS) between the returned and non-returned questionnaires. Some 74.5% of the patients were using the OA at the time of questionnaire distribution. Non-users had a higher BMI and baseline ESS when compared with users. Some 74.3% of the users and 50.0% of the non-users had used a nCPAP machine before the OA therapy. Four (11.4%) of the users used an OA together with nCPAP. Only 7 (58.3%) of the non-users started or restarted their nCPAP. Some 82.9% of the users wore their OA more than 3 days a week. 77.8% of the non-users stopped using the OA in the first three months and the most common reason given was ‘uncomfortable'. Many users complained about a dry mouth and/or excessive salivation and non-users significantly complained more about ill-fitting appliances. Over 80% of the users experienced an improvement in their snoring, daytime sleepiness and witnessed apneas, and specific users reported the reduction of headaches and lowered blood pressure. More than 60% of the users were satisfied with their OA therapy.

Conclusions: Non-users complained more about ill-fitting appliances when compared to users and “uncomfortable” was the main reason given to discontinue therapy. Since the TheraSnore^TM is a ready made appliance available in only one standard size, by design it may result in a less than optimal fit and subsequently decrease overall compliance.